Three cases of IMP-type metallo-β-lactamase-producing Enterobacter cloacae bloodstream infection in Japan.

Abstract

We report three cases of IMP-type metallo-β-lactamase-producing Enterobacter cloacae bloodstream infection, which showed minimum inhibitory concentration values for imipenem with 2 μg/ml in all isolates. Although carbapenems were initiated empirically in all cases, two of three cases died. The Clinical and Laboratory Standards Institute lowered the breakpoints of carbapenems for Enterobacteriaceae in 2010. However, the previous breakpoints are still used in many clinical laboratories, which can result in failure to detect carbapenem-resistant Enterobacteriaceae. Therefore, lower breakpoints of carbapenems should be used in clinical settings, and alternative tests for detecting metallo-β-lactamase such as polymerase chain reaction and immunochromatographic assays may contribute to better detection of carbapenem-resistant isolates.

• Authors: Yohei Hamada, Koji Watanabe, Tatsuya Tada, Tada Tatsuya, Kazuhisa Mezaki, Sosuke Takeuchi, Toshio Shimizu, Teruo Kirikae, Norio Ohmagari
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 19 Issue 5 Pg. 956-8 (Oct 2013) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 23160627 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Bacterial Proteins
• beta-Lactamases

Topics

• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Bacteremia (drug therapy, microbiology)
• Bacterial Proteins
• Enterobacter cloacae (drug effects, enzymology, isolation & purification)
• Enterobacteriaceae Infections (drug therapy, microbiology)
• Humans
• Japan
• Male
• Microbial Sensitivity Tests
• beta-Lactam Resistance
• beta-Lactamases (biosynthesis)